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Question:

Dear Sir /Madam,
My father is stage 4 cancer, he has a mass of 6cm in the stomach, metastases 6-7 masses in liver, and some other parts. we were told that it was too late for chemothreapy and / or for operation.

So while we are searching for alternatives, we found out DCA and wanted to try as our last chance. He is given very little short time.  we already ordered the drug and would like to start using it as soon as possible but we have one important question: our father has aproblem with his kidneys as they are half functioning, this is one of the key reasons they would not apply chemothreapy to him since it can result to kidney failure on top of the cancer and spend his last days going to dialysis, so regarding using DCA is there any side effect concerning kidneys, would it result in kidney failure, what dosage should we use as he is at the last stage? Kurtulus.

Answer:

Dear Kurtulus,

This is a hard question to answer. We haven't found scientific evidence that DCA could damage the kidneys.:

''The drug does not alter renal concentrating ability or amino acid excretion. It slightly increases urinary lactate and pyruvate excretion, probably by inhibiting the specific tubular reabsorption of these anions.

Of note, in the phase Ib clinical trial for GBM, the researchers have observed no other toxicity from DCA, including abnormalities in cardiac function, renal function, or liver tests.''

This means that there is no available evidence of Sodium dichloroacetate damaging the kidneys. In fact, there is one in vivo research which states that DCA could even help protect the renal function from some chemotherapy toxicity when used in combination (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084882/).
!N.B. This doesn't apply if the patient has Polycystic kidney disease. One should avoid DCA when suffering from this condition.

Regarding the question about dosing in such a situation. The best solution would be to try 50 mg/kg I/V DCA injections. However, when intravenous DCA is not available and one has kidney failure - please try 25 mg/kg DCA powder perorally for one-two weeks first. If the patient tolerates the medication without side effects, you can continue with such a dose or increase it.

Don't forget to take breaks and don't forget that DCA shouldn't be taken when suffering from severe hepatic impairment.